Individual
CONRAD J GORMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
5505 ROSWELL RD STE 100, ATLANTA, GA 30342-1983
(404) 480-9330
Mailing address
5505 ROSWELL RD STE 100, ATLANTA, GA 30342-1983
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
8820
GA
Other
Enumeration date
07/18/2018
Last updated
07/18/2018
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